JP5818214B2 - Ventilator - Google Patents

Description

  The present invention relates generally to ventilators, ventilator systems and methods for humans and other animals. More particularly, the present invention relates to a ventilator that can be made with minimal resources, thereby enabling low cost mass production.

[Related application data]
This application claims the benefit of US Provisional Application No. 61 / 260,296, filed November 11, 2009. The entire disclosure of this provisional application is expressly incorporated herein by reference.

  Surge capacity ventilators during influenza pandemics require devices capable of transmitting positive pressure ventilation ("PPV") and positive end-tidal pressure ("PEEP"). The disease duration can last from days to weeks and may require artificial respiration for more than a week. One of the most dangerous consequences of severe influenza infection is acute respiratory distress syndrome (“ARDS”). ARDS is the most frequent severe complication of influenza and is characterized by diffuse inflammation of the lungs leading to gas exchange disorders.

  Ventilators currently on the market range from expensive, high-performance machines to simple, low-cost portable devices. ARDS patients require high-performance ventilators capable of PPV and PEEP to overcome alveolar collapse, which is increased by inflammation. Full-featured machines on the market today are very expensive, fragile and very complex for use by unskilled personnel. In addition, portability and durability are limited, and constant power supply is required. For these reasons, full-featured machines are not suitable for use in the field environment, in the countryside, or in large-scale emergencies such as pandemics.

  Currently marketed portable ventilators are designed to be used as a temporary bridge while a patient moves into or out of a fully equipped ventilator. While they are easier to carry than full-featured ventilators, portable ventilators are not suitable for use with ARDS patients during a pandemic. They do not provide PEEP, do not have a spontaneous breathing support mode, and are not approved for use in intensive care. Inefficient use of compressed air and electricity is also inappropriate for low resource environments and developing countries.

  At present, inexpensive artificial resuscitators are commercially available for less than $ 200. These devices are designed as a last resort in an emergency and always require direct monitoring. They are not commonly used to support patients with ARDS for clinically relevant periods.

  When considered globally, the disparity of resources for the pandemic between rich and poor countries is alarming. Given that most of the world's vaccine supply has already been purchased by wealthy countries, the coverage of developing countries may be inadequate. Many countries are already facing extreme shortages of ventilators, even in the absence of a pandemic. For example, in the United States, there are approximately 205,000 ventilators for a population of 300 million. In India, the population exceeds 1.1 billion, but only 35,000 intensive care ventilators are available. What is needed to resolve this imbalance is a very low cost ventilator that is specifically adapted to meet the demands of acute respiratory distress patients in resource-poor, rural and emergency environments. is there.

  The present invention is generally directed to ventilators and ventilation (ventilation) systems and methods for humans and other animals. For example, the ventilators described herein can be made with minimal resources, thereby enabling, for example, low-cost mass production.

  According to an exemplary embodiment, a source of pressurized gas, a patient vessel, a first pressure sensor connected to the patient vessel and detecting the pressure of the ventilation gas in the patient vessel, and a valve assembly For example, communicating with a gas supply source via a source line, communicating with a patient container, and communicating with an inhalation line for delivering ventilation gas to the patient 1 or A ventilator system is provided that includes a valve assembly that includes more valves. The controller is connected to a valve assembly that is connected to the patient via a storage configuration in which ventilation gas is sent from the gas source into the storage container and from the storage container to the patient via the inspiratory line. Can be selectively switched between delivery configurations. The controller is connected to the first pressure sensor and detects the first pressure in the storage container when the valve assembly is in the supply mode, and thereafter, the ventilation gas passes from the storage container through the intake line. Later pressure can be detected while being delivered to the patient. The controller determines the amount of ventilation gas delivered to the patient based at least in part on the difference between the first pressure and the subsequent pressure.

  According to another embodiment, the pressurized gas supply source, the pre-fill vessel, the patient container, and the gas supply source communicate with each other via the source line, and the prefill container and the patient container are connected to each other. A valve assembly that communicates with and communicates with an inspiratory line for sending ventilation gas to the patient, and is connected to the valve assembly, and the venting gas is sent from the patient container to the patient through the inspiratory line and pressurized. Between the supply mode in which the gas is sent from the gas supply source to the prefill container and the storage mode in which the pressurized gas is sent from the gas supply source and the prefill container into the storage container and the pressurized gas is stored in the storage container A ventilator is provided that includes a controller that selectively switches at.

  According to yet another embodiment, a method is provided for ventilating a patient including the step of bringing the patient's airway into communication with the inspiratory line of the ventilator. The ventilator includes an internal storage container and a source of pressurized gas. In the storage stage, ventilation gas is sent from the gas supply source to the storage container, and in the supply stage, ventilation gas is sent from the storage container to the patient via the inhalation line. In the supply stage, a change in pressure in the storage container may be measured to determine, for example, the amount of pressurized gas sent from the storage container to the patient. The ventilator is independent of the duration of the inspiratory phase, based at least in part on changes in pressure in the reservoir and / or without measuring the flow rate of ventilation gas delivered to the patient. It may be actuated based at least in part on the change in pressure within.

  According to yet another embodiment, the following steps are performed: a) With the reservoir container separated from the ventilator gas source, the ventilation gas is routed from the reservoir container in the ventilator via the inspiration line. And b) measuring a change in pressure in the reservoir while ventilation gas is being sent from the reservoir to the patient; and c) delivering to the patient based at least in part on the change in pressure. Determining the amount of ventilation gas produced; d) stopping the supply of ventilation gas from the reservoir to the patient; e) sending ventilation gas from the gas supply source to the reservoir and pressurizing the reservoir And replenishing with a method of performing artificial respiration of a patient, comprising continuously performing one or more times.

  In one embodiment, the step of measuring the change in pressure comprises measuring a first pressure in the storage container before or immediately after starting to send ventilation gas from the storage container to the patient; Measuring the pressure in the storage container at preset time intervals while the ventilation gas is being delivered to the patient, wherein the amount of ventilation gas delivered to the patient is a first pressure and a subsequent pressure. Is determined based at least in part on the difference between For example, the cumulative amount of ventilation gas delivered during each time interval is compared to a preset maximum amount and when the estimated cumulative amount reaches or exceeds the preset maximum amount, The supply of ventilation gas may be stopped. In another embodiment, the pressure in the reservoir is monitored while ventilating gas is delivered from the reservoir to the patient, and the time derivative of the pressure is reduced to a pre-set threshold and derived until it approaches zero. The supply may be stopped as soon as the differential value falls to the threshold value.

  According to yet another embodiment, a housing, a source of pressurized ventilation gas, a valve in the housing that controls the flow of ventilation gas sent to the patient via the inspiration line, and a compressor to the patient. There is provided a ventilator comprising a flow restrictor for restricting a flow rate of the ventilation gas, wherein the flow restrictor is disposed in the inspiratory line after the valve. The flow restrictor may be manually adjustable to change the maximum flow that can be delivered to the patient via the inspiratory line and / or may be separate from the controller that controls the valve.

  According to yet another embodiment, the housing, a source of pressurized ventilation gas, and one or more in the housing in communication with the gas source and the inspiratory line for delivering ventilation gas to the patient. And a ventilator wherein one or more valves are operable only in a fully open state or a fully closed state to control the flow of ventilation gas to the patient. Provided.

  According to yet another embodiment, ventilating the patient's airway with the inspiratory line of the ventilator and creating a substantially continuous flow of pressurized gas within the ventilator. Operating the compressor in the ventilator substantially continuously; intermittently delivering pressurized gas from the ventilator to the patient; and at least a portion of the flow of pressurized gas from the compressor in the ventilator And providing a method for ventilating a patient.

  In one embodiment, at least a portion of the flow of pressurized gas is stored in a patient container of a ventilator and the pressurized gas that is intermittently sent to the patient is sent from the patient container. Good. For example, the ventilator may divert a portion of the pressurized gas flow to the prefill container when the pressurized gas is sent from the patient container to the patient. When at least part of the flow of pressurized gas is stored in the patient container, at least part of the flow of pressurized gas bypassed to the prefill container is sent to the patient container and stored in the patient container. The amount of pressurized gas being applied and / or the pressure may increase.

For example, the compressor may produce a substantially continuous flow of pressurized gas at a flow rate between about 8 and 12 liters per minute (8-12 lpm). In another example, the portion of the pressurized gas flow stored in the patient container is within a peak of at least 350 cc H ₂ O (5 psi), at least 700 cc H ₂ O (10 psi), or at least 1100 cc H ₂ O (15 psi). A pressure may be generated in the patient container. In yet another embodiment, the maximum pressure in the inspiratory line during the supply of ventilation gas to the patient may be 70 cc H ₂ O (1 psi). Additionally or alternatively, the ratio between the peak internal pressure in the patient container and the maximum pressure in the inspiratory line may be at least 2 or 5.

  According to yet another embodiment, an artificial respiration system comprising a pressure source, a first valve (eg, a solenoid valve assembly), a first actuator configured to actuate the first valve, and a conduit. Provided. The first valve is an electronic device and may use about 1.2W to about 4.8W during normal operation. The controller can initially apply a larger voltage to the valve while it is open, for example to speed up its opening, and then reduce the voltage and hold the valve open, Thereby, for example, the power consumption of the valve can be reduced. The artificial respiration system may be configured to attach to a pressure source. For example, the pressure source can be a central air pressure supply line (eg, that passes through the wall of a medical facility) that can be connected to a ventilation system, a substantially constant volume pressure vessel (eg, a pressurized air tank), and / or ventilation. It may be an internal or external compressor to which the system can be connected.

  The ventilation system can include one or more solenoid assemblies. For example, the solenoid assembly can include a first actuator having a first solenoid. The artificial respiration system can also include a second valve (eg, a discharge valve). The first actuator can be configured to actuate the first valve and / or the second valve. The solenoid assembly can include a second solenoid that operates the second valve. In different settings, the solenoid valve assembly delivers air from a pressure source to one or more pressure vessels (ie, refills the pressure vessels) and / or delivers air from the pressure vessels to the patient via the inspiratory line. You may make it send.

  The solenoid valve assembly can control a large amount of air flow, for example, with a small solenoid valve that requires a low power of, for example, less than about 3 watts or less than about 1.6 W.

  The system can be operated in one or more different modes as required, for example, control mode ventilation (ie, “CMV”), assist and control (“A-C”), continuous airway It can be controlled between positive pressure (“CPAP”) and / or biphasic positive airway pressure (“BiPAP”) modes.

  According to another embodiment, an artificial respiration system for providing artificial respiration to a patient, comprising a pressure source, a first pressure vessel, a second pressure vessel, and a conduit configured to communicate with the patient. Provided. The device includes a first valve, and a pressure source can be in communication with the pressure line via the first valve. Further, the pressure source can be communicated with the pipe line.

  According to yet another embodiment, a method of performing patient ventilation is provided that can include communicating the patient's airway with a ventilator having a pressure vessel. The method can include measuring a change in pressure within the pressure vessel. The method can include activating the ventilator based at least in part on a change in pressure within the pressure vessel. For example, the ventilator can be operated during various operating phases, for example during the supply or inspiration phase and / or the storage or expiration phase, without measuring the flow rate.

  The method can include delivering gas from the patient container to the patient's airway. The pressure vessel may be a rigid and constant volume structure such as a gas tank. The pressure in the pressure vessel may decrease during the delivery of gas to the patient's airway. The method can include measuring a change in pressure within the pressure vessel to determine the amount of gas discharged from the pressure vessel. The method can include displaying the amount of gas exhausted from the pressure vessel on an output device, such as a display or other user interface.

  According to yet another embodiment, a method of performing patient ventilation is provided that includes communicating the patient's airway with a ventilator. The ventilator can include a pressure vessel, and the method can include measuring a change in pressure within the pressure vessel. The method can include activating the ventilator based at least in part on a change in pressure within the pressure vessel.

  The systems and methods presented herein can provide the clinical functionality of modern ICUs or portable machines at an order of magnitude less than other systems. Furthermore, the systems and methods herein can be operated with minimal power and / or without the need for external or compressed oxygen.

  The above summary is not intended to describe each embodiment or every implementation of the present invention. Rather, a more complete understanding of the present invention will become apparent and appreciated by referring to the following detailed description and claims in view of the accompanying drawings.

Note that the exemplary systems and methods shown in the drawings are not necessarily drawn to scale, emphasis instead being placed upon illustrating various aspects and features of the illustrated embodiments. The following drawings illustrate exemplary embodiments.
FIG. 1 is a schematic diagram of an exemplary embodiment of a ventilator showing the air and data flow between the ventilator components. FIG. 2 is a detailed view of the ventilator of FIG. 1 showing an exemplary arrangement of ventilator gas flow and control elements. FIGS. 3A and 3B are time synchronizations of patient airway pressure circulation and pressure vessel pressure circulation during the performance of an exemplary method of operating a ventilator system, such as the ventilator of FIGS. 1 and 2, respectively. Is a graph. FIG. 4 is a flowchart illustrating an exemplary algorithm for operating a ventilator, such as the ventilator of FIGS. FIG. 5A is a front view of an exemplary user interface panel that may be provided on a ventilator housing, such as the ventilator of FIGS. 1 and 2. FIG. 5B illustrates an exemplary embodiment of a ventilator system including a ventilator housing and a display readable in both horizontal and vertical directions.

  Referring to the drawings, FIG. 1 shows an exemplary embodiment of a ventilator system 10, such as a portable ventilator that includes a relatively lightweight housing 12 that holds various components of the system 10. . In general, system 10 is connected to gas source 20 via source line 22 and one or more source lines 22 that receive gas from one or more sources 20 of compressed gas, as described further below. And / or an array 40 including, for example, one or more storage containers and / or valves connected to the inspiratory line 24 for delivering gas to the patient. For example, as shown in FIG. 2, the array 40 can include a valve assembly 46 that includes one or more valves connected to one or more storage vessels 42. The system 10 can also include one or more controllers 60, which are connected to the array 40, for example, to operate one or more valves of the array 40, and are connected to one or more controllers 40. Connected to a pressure sensor 70 that provides pressure data from one or more components of the system 10, for example, and / or to other components of the system 10.

  Optionally, the system 10 may include one or more additional components, such as one or more user interfaces 62, a power source 64, a flow restrictor 72, retained in the housing 12, as further described below. Valves 76 and 78, filters, and the like can also be included. Additionally or alternatively, the system 10 can include one or more external components, such as a source of compressed gas and / or liquid, a power source, a tube, a valve, etc. (not shown) and a housing 12 may include various connectors for connecting such components to system 10, such as pneumatic or electrical connectors (also not shown).

  In general, the ventilator system 10 can controllably communicate gas to the patient via the inspiratory line 24 and external tubes and / or other components connected to the inspiratory line 24. The ventilator system 10 can control the flow rate and / or amount of gas delivered to the patient and / or can control resistance to exhalation from the patient, for example, as described further below. . It should be noted that regardless of whether the particular fluid involved is under a positive gauge pressure (“pressurized”) or substantially zero gauge pressure (“ambient”) air, Even if it is oxygen, etc. and / or the particular fluid involved includes other fluids such as anesthetics, nitrous oxide, carbon dioxide, etc., “gas” or “ It should be noted that the term “air” may be commonly used herein.

  Still referring to FIG. 2, an exemplary configuration of a source of pressurized gas 20 is shown, which may include an air compressor 26, one or more step-down orifices or other restrictors 28, optional A prefill container 44 and an optional oxygen control valve 29 for controlling the supply of external pressurized gas into the system 10. The components of the gas supply source 20 and / or other components connected along the gas flow path include one or more pipes or other conduits, manifolds, etc. (not shown) as required. It may be connected to the above flow path.

The compressor 26 may be any device that can draw ambient air or other gas into the system 10 and compress that gas to one or more desired pressures for delivery to the source line 22. . The compressor 26 generally includes one or more inlets, for example, an inlet 26a that communicates with a control valve 29 to draw gas into the compressor 26, and an outlet 26b that provides pressurized gas to the source line 22. Including. Alternatively, the compressor 26 receives a plurality of inlets (not shown), such as an inlet for drawing ambient air into the compressor, and a note for receiving gas from the oxygen control valve 29 or other external source. And an inlet. If the compressor 26 draws ambient air from an area outside the housing 12, one or more filters (not shown) are optionally connected to the compressor inlet 26a to remove dust or other debris. It may be provided on the upstream side. In an exemplary embodiment, the compressor 26 may be capable of delivering a pressure of about 700 cmH ₂ O (centimeter of water) (10 psi) or greater, or a pressure of about 350 cmH ₂ O (5 psi) or greater.

  The oxygen control valve 29 can be a constant volume source, such as a cylinder or tank, a substantially continuous source, such as an air or oxygen supply line from a hospital or other medical facility, a concentrator, an external pump or compressor. Etc. (not shown) can be connected to one or more external sources of gas. Optionally, the oxygen control valve 29 can include a bypass valve or position. Further, if necessary, a line (not shown) for bypassing the compressor 20 can be provided instead of directly transferring the gas from the external supply source to the source line 22.

  As shown, the oxygen control valve 29 can include two inlets 29a, 29b that can be connected to different external gas sources. For example, the inlet 29a can be connected to one or more external sources of air, eg, ambient air and / or compressed air, while the inlet 29b is pure oxygen, eg, low flow oxygen and It can be connected to one or more external sources of compressed oxygen. Each line communicating with the inlets 29a and 29b of the oxygen control valve 29 may include step-down regulators 28a and 28b so that the maximum predetermined pressure is not exceeded, for example, when the external supply source includes compressed gas. it can. The housing 12 may include a connector (not shown) that connects an external source to the system 10 for transmission into the oxygen control valve 29 and the compressor 26.

  The oxygen control valve 29 can control the ratio or mixing of gas from an external source that communicates with the inlets 29 a, 29 b that is communicated to the compressor 26. For example, the oxygen control valve 29 may be a multi-position device, such as a 2-position, 3-position or 4-position regulator or control valve, which may be manually operated by a user or a controller. 60 may be electronically actuated. For example, the oxygen control valve 29 may provide about 21% (ie, no additional oxygen), about 50% or about 100% oxygen from an external source (not shown) to the compressor inlet 26a (or to the source line 22). Can have discrete settings to communicate (directly). With the approximately 100% setting of the oxygen control valve 29, the only gas delivered to the patient is substantially from the external oxygen supply. For this reason, the oxygen control valve 29 may be adjusted so as to control the ratio of released oxygen (for example, calculated as a ratio of the oxygen amount and the air amount). Alternatively, the control valve 29 can be omitted, and any external gas supply can be simply connected to the compressor 26 and / or the source line 22 via a connector on the housing 12.

Optionally, a step-down limiter (not shown) may be provided in the source line 22. For example, the limiter is independent of the source, i.e. whether the gas is from the compressor 26 or from an external source via the control valve 29, e.g. It may be an orifice or other device that regulates the gas flowing into the valve assembly 46 so that it does not exceed. For example, such a pressure step-down limiter may reduce the pressure transmitted from the source line 22, ie, from the compressor 26 and / or control valve 29, to the valve assembly 46, for example, less than about 700 cmH ₂ O (10 psi). Can be limited.

  Optionally, the gas supply 20 can include one or more containers or tanks for temporarily storing gas supplied from the compressor 26 and / or external sources. As will be discussed further below, for example, pressurized gas from the compressor 26 may be routed into the prefill container 44 and / or prefill to supplement gas transmitted to the valve assembly 46 and / or patient container 42. As shown in FIG. 2, for example, a prefill container 44 communicating with the source line 22 can be provided so that the gas stored in the container 44 is supplied into the source line 22.

  The compressor 26 and / or other components can be driven by one or more power sources, such as one or more batteries. For example, a single array of rechargeable batteries 64 can be provided in the housing 12 (shown in FIG. 1) and can be connected to all of the components of the system 10 that require power. Alternatively, separate power sources (not shown) may be provided for the compressor 26, controller 60 and / or array 40 valves as required.

  Additionally or alternatively, the power source is a connector (not shown) for connecting the system 10 to an external power source such as a generator, one or more power cells, a battery, a building wall outlet, etc. (not shown). (Omitted) can be included. When the external power source is an AC source, the system 10 can include a DC adapter (not shown) that converts power used by components of the system 10, for example, inside or outside the housing 12. . Optionally, when an external power source is connected to the system 10, the system 10 may selectively or automatically charge one or more batteries.

  Optionally, ventilator system 10 includes a CPAP or BiPAP circuit (not shown) that can bypass valve assembly 46 to provide a selective flow path between source line 22 and inspiratory line 24. Can do. For example, a manual or automatic switch (not shown) controlled by the user and / or controller 60 opens the BiPAP circuit to prevent gas from entering the valve assembly 46. The CPAP circuit may include a line that connects directly from the source line 22 to the inspiratory line 24 to convey a substantially continuous flow of pressurized air or other gas to the patient at a predetermined pressure. Alternatively, the BiPAP circuit can carry a substantially continuous flow of pressurized gas at two or variable pressures. The CPAP or BiPAP circuit can include a fixed or variable flow restrictor for delivering a substantially continuous flow of pressurized gas to the patient at one or more predetermined pressures. The controller 60 can be connected to a BiPAP or CPAP switch (not shown) in the circuit, and when operating in BiPAP or CPAP mode, the controller 60 passes the pressurized gas from the gas supply 20 to the BiPAP or CPAP circuit. BiPAP or CPAP switch can be adjusted to route through and bypass valve assembly 40.

  With particular reference to FIG. 2, system 10 generally includes one or more reservoirs or tanks, eg, patient reservoirs 42, for storing pressurized gas, and valve assembly 46 includes patient containers 42, supply lines. One or more valves for directing the flow of pressurized gas between 22 and / or the intake line 24 are included. In the illustrated exemplary embodiment, the valve assembly 46 may include a single valve, such as an electromechanical solenoid valve assembly, a hydraulic valve assembly, a pneumatic valve assembly, etc., for example, a three-port two-position solenoid valve.

  For example, as shown, the solenoid valve assembly 46 includes an inlet port 46a connected to the source line 22, a port 46b from the solenoid valve assembly 46 for connection to one or more reservoirs 42, and an intake line. 24 to the outflow port 46c. Thus, the solenoid valve assembly 46 can control the flow of gas from the gas supply source 20 and source line 22 to the patient container 42 and from the patient container 42 to the inspiratory line 24, as further described below.

  Alternatively, valve assembly 46 may include two or more valves, which are selected flow paths through ventilator 10, such as source line 22 and patient, as described below. The first flow path between the containers 42 and the second flow path between the patient container 42 and the inhalation line 24 can be opened or closed. Thus, in either embodiment, the valve assembly 46 is switched between two or more aspects, eg, between a storage aspect and a supply aspect, as further described below. As described further below, in the supply mode, for example, the first flow path can be opened between the patient container 42 and the inspiratory line 24 to send ventilation gas from the patient container 42 to the patient, For example, a flow path can be formed between the gas source 20 and the patient container 42 to send pressurized gas to the patient facilitator 42 to reinject or refill the patient container 42.

In general, the patient container 42 is sized to approach the predicted maximum tidal volume, i.e., a single bolus of gas administered to the patient during a single inhalation, at the predicted maximum container pressure. The For example, patient container 42 may contain up to about 2,000 cubic centimeters (2,000 cc) of gas at about 56 cm H ₂ O in the patient to deliver a breath of 800 cc at about 40 cm H ₂ O in the patient. Or about 60 cmH ₂ O can contain up to about 400 cubic centimeters (400 cc) of gas in a container to deliver a breath of 800 cc at 20 cm H ₂ O in a patient. Also, the container volume and maximum pressure may vary based on resistance to gas flow in the ventilator or patient circuit. As an example, a relatively high pressure or large container may be desired to increase gas flow to the patient. Thus, patient container 42 can be a substantially rigid cylinder or other closed container having a volume of about 400 to 2,000 cubic meters (400-2,000 cc).

  Alternatively, the system 10 includes two pressure vessels, for example, a large patient pressure vessel and a small patient pressure vessel (not shown) as described in provisional application 61 / 260,296. Where the system 10 includes multiple pressure vessels, the pressure vessels may be structurally the same in size and / or shape, or may have different sizes and shapes. In this option, the valve assembly 40 is in data communication with the controller 60 and / or is under control of the controller 60, for example, to control the flow between the container and / or other lines of the system 10. Or more pressure vessel switches (not shown) can be included. For example, when actuated by the controller 60, the pressure vessel switch may move from the patient vessel to the valve assembly 46, and vice versa, and / or from the patient vessel, as described in application 61 / 260,296. The gas flow can be directed to one or both of these, or vice versa.

  Patient container 42 may include one or more pressure sensors, such as patient container pressure sensor 70a. Optionally, if system 10 includes a pediatric (or other additional) reservoir (not shown), the pediatric reservoir may be a pediatric reservoir pressure sensor (also not shown). One or more pressure sensors may also be included. Reservoir pressure sensor 70a can be disposed within the internal volume of patient container 42, or can be disposed adjacent to, but need to be connected to, the internal volume of patient container 42. The pressure sensor 70a can be connected to the controller 60, for example, to provide pressure data for the patient container 42 to the controller 60, as described further below.

  Optionally, the system 10 can include one or more additional pressure sensors that connect to the controller 60 to provide pressure data that can be used by the controller 60 during operation of the system 10. Can do. For example, the system 10 can include an ambient pressure sensor 70 b that is exposed to external ambient pressure to provide the controller 60 with ambient pressure data.

  The patient airway sensor 70c can also be provided in the inspiratory line 24, for example, to detect pressure in the inspiratory line 24 at a location where the inspiratory line 24 communicates with the patient's airway, as will be further described below. .

The ventilator system 10 may also include one or more regulators and / or valves, for example, in the inspiratory line 24 and / or the expiratory line 74 of the system 10. For example, the flow restrictor 72 can be provided in the inspiratory line 24, for example, between the patient 90 and the valve assembly 46. The flow restrictor 72 can be configured to limit the inspiratory pressure delivered to the patient to a maximum value of, for example, about 60 cmH ₂ O (0.9 psi). Optionally, the flow restrictor 72 can be adjusted to control the flow of ventilation gas delivered to the patient during inspiration. For example, the flow restrictor 72 can be manually adjusted to change the maximum flow rate that can be delivered to the patient 90 via the inspiratory line 24, for example, such that the flow restrictor 72 is disconnected from the controller 60. For example, the flow restrictor 72 can be adjusted via a knob or other control (not shown) on the housing 12 or by direct access to the flow restrictor 72. Alternatively, if desired, the flow restrictor 72 can, for example, cause the controller 60 to activate the flow restrictor 72 to adjust the maximum flow based on user input and / or operating parameters of the system 10. Thus, the controller 60 can be connected.

Optionally, the ventilator system 10 can include a pressure relief valve (not shown), for example, also in the flow restrictor 72 and the inspiratory line 24 downstream of the patient 90. The pressure relief valve may be configured to automatically open and release excess pressure that may occur in the intake line 24, for example, to limit the intake pressure to a pressure of about 60 cmH ₂ O (0.9 psi) or less. it can.

  A patient airway sensor 70c may be provided in the inspiratory line 24 downstream of the flow restrictor 72 and / or downstream of the pressure relief valve adjacent to the connection to the patient circuit outside the housing 12, for example. . The controller 60 can be connected to a patient airway sensor 70c to detect the inspiratory pressure to which the patient is exposed. For example, the controller 60 may use data from the patient airway sensor 70c to determine airway peak pressure, airway static and / or dynamic pressure, and / or other parameters.

A separate pressure sensor 70b is used to measure ambient pressure. Ambient pressure sensor 70b, in combination with data from airway pressure sensor 70c, returns data to controller 60 that is used to determine the patient's respiratory trigger (-2 to -5 cmH ₂ O change). As described further below, a calibration routine can be performed for each new patient. During the calibration process, the patient circuit is connected and covered with a lid, and the controller 60 circulates the ventilation gas air through the circuit and records the amount, which is more than the physiological tidal volume. It is subtracted from the displayed tidal volume to give a close estimate.

  In addition, the ventilating system 10 can include an expiratory block, for example, outside the housing 12, through which the patient can exhale. For example, as shown in FIG. 2, the exhalation block can include an exhalation valve 76 and a PEEP (“positive end-tidal pressure”) valve 78 that connects to an external tube in communication with the inspiratory line 24 Can do. One or both of these valves 76 and 78 may be removable, disposable and / or washable for reuse, or permanently attached to a tube, housing or other component of the system 10. May be used.

  The discharge valve 76 can be configured to be open to the atmosphere during exhalation and closed during inhalation. The discharge gas line 77 can communicate, for example, from the valve assembly 46 to the discharge valve 76, and optionally a valve, such as a two-port solenoid valve (not shown), for air flow into the discharge valve gas line 77. In order to control, it may be provided in the discharge valve gas line 77. The discharge valve 76 can deliver exhalation from the patient 90 between the PEEP valve 78 and any discharge valve, eg, a substantially zero resistance discharge solenoid valve (not shown). The discharge valve is connected to the controller 60 and / or a power source (not shown) and is selectively opened and closed. For example, when the discharge valve is opened, the discharge valve 76 can send exhaled gas out of the open discharge valve. When the discharge valve is closed, the discharge valve 76 can deliver exhaled gas to the PEEP valve 78. The discharge valve may be integral with the discharge valve 76 or may be a component attached separately from the discharge valve 76.

The PEEP valve 78 may be automatically and / or manually adjustable to set the desired PEEP pressure and / or may be a spring loaded valve. For example, the PEEP valve 78 can be connected to the controller 60, which can actuate a motor or solenoid (not shown) within the PEEP valve 78 to regulate the PEEP pressure. The PEEP pressure can be, for example, between about 0 H ₂ O (0 psi) and about 30 cm H ₂ O.

  As described above, the controller 60 can be connected to various components of the system 10, for example, to receive data and / or to control the operation of the various components of the system 10. The controller 60 controls one or more hardware components, such as one or more processors, memory, storage devices (not shown), and / or one or more aspects of the operation of the apparatus 10. Software modules can be included. The controller 60 can be connected to a user interface 62 including one or more displays, input devices, etc., thereby displaying operating parameters and / or other information regarding the system 10 and / or allowing the user to set parameters Can be set, or input to the operation of the system 10 can be provided.

  For example, the controller 60 receives pressure data from a patient container pressure sensor 70a, an ambient pressure sensor 70b, a patient airway sensor 70c, and / or other pressure sensors (not shown) of the ventilator system 10, and one or more. To display and / or operate the system 10 based at least in part on the acquired pressure data. The controller 60 may send control data to and / or receive control data from the valve assembly 46, BiPAP switch, discharge solenoid valve, and / or other operable components of the system 10.

Using data from the patient container pressure sensor 70a, the controller 60 can determine tidal and minute ventilation based at least in part on the pressure drop from the beginning of inhalation. For example, the controller 60 changes the preset pressure based on the pressure data from the patient airway sensor 70c, for example, 0.01 seconds to 0.5 seconds. The patient's onset of breathing can be detected when a change of about −2 cmH ₂ O (0.03 psi) is detected within .3 seconds, eg, about 0.2 seconds.

  The user can set the performance characteristics of the artificial respiration system 10 to the controller 60 via the user interface 60. For example, the user can set inspiratory pressure, oxygen concentration, inspiratory to expiratory ratio, PEEP pressure, or a combination thereof.

  The controller 60 can control the mode of ventilation, for example, by controlling the valve assembly 46, BiPAP switch, and / or other components of the system 10. For example, the controller 60 may control mode ventilation (“CMV”), assist control (“A-C” or “A / C”) mode ventilation, or BiPAP or CPAP as described elsewhere herein. It can be used to set the ventilator system 10 to operate in one or more modes, such as mode ventilation.

  In controlled mode ventilation, the ventilator system 10 can deliver individual discrete pressurized volumes of air (“ventilator breathing”) to the patient at a substantially constant rate. The ratio of inspiration to expiration can be, for example, 2: 1, 1: 1, 1: 2, 1: 3, or 1: 4. The inspiratory flow rate can be, for example, a respiratory rate between about 0 and 60 (0-60) per minute. The ventilator system 10 can be controllable to adjust the respiration rate per minute with an increase in the respiration rate per minute.

The assist control mode ventilation, the patient (e.g., patient inspiration is, when causes a change in pressure -2cmH 2 O _(0.03psi) detected by the patient pressure sensor) to initiate the intake it can. Thereafter, the controller 60 can control the valve assembly 46 to send ventilation gas from the patient container 42 into the inspiratory line 24 and / or the flow restrictor 72. If the patient's inspiration is not detected within a given time, ie, about 2 seconds to about 8 seconds, eg, about 6 seconds, the controller can cause the ventilator to breathe. The user can adjust a ventilation timer, for example, via the user interface 62 to set the time before the controller 60 causes the ventilator to breathe.

  In the BiPAP or CPAP mode, the controller 60 bypasses the valve assembly 46 and delivers pressurized gas from the source line 22 via the BiPAP (or CPAP) circuit to provide a substantially continuous gas pressure to the patient. A BiPAP (or CPAP) switch can be adjusted to send.

  The system 10 is also configured to operate in synchronous intermittent forced ventilation (“SIMV”) mode and pressure support SIMV (“PS-SIMV”) mode. When the patient recovers from dyspnea, the patient can be removed from the ventilator and returned to spontaneous breathing. Detachment from the ventilator can be accomplished using a synchronized patient-initiated mode of ventilation, such as a synchronous intermittent mandatory ventilation (SIMV) mode or an assist control mode.

  The SIMV provides a preset number of ventilations that are synchronized with the patient's natural and self-help efforts. In PS-SIMV mode, each breath initiated by the patient is assisted with a preset amount of pressure selected by the operator.

  In SIMV mode, the ventilator system 10 can use the same inspiration induction algorithm used in A / C mode to detect spontaneous inspiration. However, this respiration is not assisted by the positive pressure from the system 10. Instead, when the SIMV mode is selected, the discharge valve 76 is opened and the patient inhales ambient air with PEEP and does all of the work of breathing himself. The discharge valve 76 can be kept open during the SIMV mode except during the inspiratory cycle of the ventilator.

  In general, with further reference to FIG. 2, the air flow through the operating system 10 will now be described. As described above, the pressurized gas is supplied from the compressor 22 and / or one or more external sources (not shown) and supplied to the source line 12, for example. Pressurized gas from the source line 22 is communicated to the valve assembly 46, which controls the flow to the patient container 42 and / or the inspiratory line 24. For example, during the storage phase, the valve assembly 46 is directed to a storage mode that opens the flow path from the source line 22 to the patient container 42. For this reason, pressurized gas is sent into the patient container 42 to reinject or refill the patient container 42. During the supply phase, the valve assembly 46 is directed to a supply mode that opens the flow path from the patient container 42 to the inspiratory line 24. For this reason, ventilation gas from the patient container 42 is supplied to the patient via the inhalation line 24, and the patient container 42 and the inhalation line 24 are separated from the source line 22.

  If the system 10 includes a prefill container 44, the prefill container 44 can always maintain a connection with the source line 22. For example, during the supply phase, the prefill container 44 receives pressurized gas from the compressor 26 or an external source, while during the storage phase, the prefill container 44 can supplement the pressurized gas sent to the patient container 42. .

  A pressure sensor 70a connected to the patient container 42 provides pressure data to the controller 60, which uses the data to at least partially or based on a pressure drop from the beginning to the end of inspiration. To determine tidal volume and / or minute ventilation.

The flow restrictor 72 limits or controls the flow rate of the ventilation gas sent to the patient via the inspiration line 24 during inspiration. Downstream of the flow restrictor 72, the ventilation gas has a pressure relief valve set to open, for example, at about 60 cm H ₂ O, and a patient airway sensor 70c, for example, located at a connection point to an external patient circuit. Pass through. Patient airway sensor 70c returns data to controller 60, which uses the data to determine peak airway pressure. This may be displayed on the control panel of the user interface 62. The air exhaled by the patient returns through the discharge valve 76, and the discharge valve is opened to the atmosphere during exhalation while being kept closed during inspiration. A discharge gas line valve (not shown) is driven by the same or different power source as the other components of the system 10 but controls the flow of air flowing into the discharge valve gas line 77. Exhaled air passes through a positive end-breath pressure (PEEP) valve 78 before exiting the device.

The ambient pressure sensor 70b is used to measure the ambient pressure. The controller 60, together with data from the patient airway sensors 70c, for example, when determining the start of the patient's breathing (-2 to -5cmH ₂ O change in), using data from the sensor 70b.

  Prior to use of the system 10, a calibration routine may be performed for each new patient. During the calibration process, the external patient circuit is connected to the inspiratory line 24 and covered with a lid. The system 10 is then operated to circulate the ventilation gas through the circuit, the controller 60 records the measured amount, and the measured amount is subtracted from the displayed tidal volume to provide a physiological one. A more accurate estimate of tidal volume is given.

  3A and 3B show the pressure parameters of the system 10 when operating in assist / control mode ventilation. As shown in FIG. 3A (further referring to FIG. 2), the patient's inspiration attempt at point A causes an air supply from the system 10 when a predetermined drop in pressure is detected by the patient airway sensor 70c. ing. Depending on the mode selected, either a specific pressure, inspiratory time or volume limit signals the controller 60 to cause the valve assembly 46 to stop air flow to the patient via the inspiratory line 24. Let them adjust. For example, if the controller 60 is set to stop the supply at a preset peak pressure, the pressure limit is detected by the patient airway sensor 70 while the supply is stopped at a preset amount limit If the controller is set to do so, the tidal volume is detected by the patient container pressure sensor 70a. Optionally, controller 60 may track inspiration and expiration times and ambient pressure.

In order to suppress erroneous starting (automatic circulation), the controller 60 may wait for a preset minimum discharge time before analyzing the expiration pressure. For example, as shown in FIG. 3A, after the minimum discharge time has passed at point D, the controller 60 analyzes the change in pressure over time, measures dp / dt, and dp / dt is, for example, 0.1 Expiration onset can be determined when about −2 cmH ₂ O per _second is exceeded. At that time, the pressure circulation is started again.

  FIG. 3B compares the change in pressure over time between the patient airway and the patient container. As discussed above with respect to FIG. 3A, at point A, the patient attempts to inhale, which triggers the controller 60 to supply the valve assembly 46 at point B. As shown in the figure, at point B, the pressure in the patient container 42 is maximized, and immediately thereafter, the valve assembly 46 is brought into the supply mode, and the flow path between the patient container 42 and the inspiratory line is opened. . During inhalation, after point B, the pressure in the patient airway increases and the pressure in the patient container 42 decreases.

  At point C, the controller 60 uses the valve assembly 46 as a storage mode to close the flow path between the patient container 42 and the inspiratory line 24 and open the flow path between the patient container 42 and the source line 22. , Thereby stopping the supply of ventilation gas to the patient. For this reason, the pressure in the patient's airway begins to decrease. The patient source container 42 communicates with the gas source 20, eg, the compressor 26, the external source, and / or the prefill container 44 via the source line 22, thereby providing a pressure within the patient container 42 as shown. Rises between points C and E.

  FIG. 4 illustrates exemplary algorithms or instructions that the controller 60 executes during system operation, including, for example, an inspiration start algorithm that starts at the beginning of a patient exhalation placed in the system 10. It is. As described above, the controller 60 may include one or more processors, memory and other hardware components, and / or one or more software modules that perform various functions of the controller 60. For example, in one embodiment, the controller 60 may include a single electrical circuit board provided with a plurality of electrical components that operate the system 10. Alternatively, the controller 60 can be provided as a plurality of sub-controllers that control the operation of various aspects of the system 10.

  In step 110, the system 10 is initialized, for example, when an "on" switch or other input is activated from the user interface 62 and the system 10 is switched on. At that time, any registers of controller 60 are initialized and / or any hardware component of system 10 is examined and / or activated. For example, the controller 60 may store in memory (not shown) one or more parameters, eg, a “lowest slope” value for the time derivative of pressure in the patient airway during expiration of the controller 60 and / or the next run. The value for a constant or PEEP that changes during operation can be stored. In the exemplary embodiment, when the algorithm begins, the controller 60 may reset the value of PEEP in the controller memory to zero (0).

  At step 112, the controller 60 can poll the input device of the user interface 62 to determine, for example, whether the user has instructed the controller 60 to calibrate the system 10. For example, the user interface 62 may include a defined calibration button 62a (see FIG. 5A) or, for example, calibration is selected from a set of menus on a touch screen or other input device. It may be a thing. If the controller 60 determines that a calibration should be performed, the controller 60 can perform the calibration at step 114.

  The total volume of air delivered by the ventilator during a single inspiration is composed of two components: “tidal volume”, the air that actually fills the patient's lungs, and the dead space. The dead space consists of the patient's airway from the mouth to the lungs, called the “physiological dead space”, including the trachea and main bronchus, and the volume of the “patient circuit”, the flow path connecting the patient and the ventilator. Can be included. The calibration process can involve determining the amount of air in the patient circuit at a given inspiratory pressure. This amount is later subtracted from the total volume delivered from the patient container 42 during inspiration and displayed as a tidal volume. Calibration of the system 10 to obtain a more accurate tidal volume excluding the dead space is suitable for all patients, for example, for children or small patients whose tidal volume is less than or equal to the patient circuit volume. It can also be used.

  The system 10 delivers one breath, or a set number of breaths, eg, five breaths, at the inspiratory pressure set by the operator during calibration. The inspiratory pressure selected to perform the calibration process should be the same or nearly the same as the inspiratory pressure applied during patient use. The patient circuit is attached to the system 10 during the calibration process, but its end is covered with, for example, a plastic cap or the operator's thumb. The volume delivered from the patient container 42 is recorded for each breath delivered during the calibration process. As soon as the calibration process is finished, an average of these quantities is derived and stored in the memory of the controller 60. The average of the stored patient circuit volume is subtracted from all tidal volumes during subsequent delivery of ventilation gas, and the difference is displayed on the user interface 62 and / or stored in the memory of the controller 60. The The average patient circuit volume is kept in memory and / or used by the controller 60 until the calibration process is repeated or the system 10 is switched off. If the patient circuit is disconnected from the patient, the calibration process can be repeated at any time.

  Next, at step 120, the controller 60 can poll the user interface 62 to determine whether a particular mode of ventilation has been selected by the user. For example, as shown in FIG. 5A, the user interface 62 may include a mode menu 62c that can be selected by the user. Returning to FIG. 4, an exemplary selection of automatic or assist mode is shown. It should be noted here that the controller 60 and the system 10 can be operated in other modes than those two modes, as described elsewhere.

  For example, if automatic mode is selected at step 130 (or if no other mode is selected and automatic mode is the default), system 10 initiates aspiration, ie supplies valve assembly 46. In an embodiment, ventilation gas is supplied from the patient container 42 to the patient via the inhalation line 24. While ventilation gas is being delivered from the patient container 42 to the patient, the pressure in the patient container 42 is periodically monitored by the controller 60 at step 132 using, for example, the patient container pressure sensor 70a. There may be. In step 134, the controller 60 inquires whether the intake timer has expired. If not, the controller 60 returns to step 132 and continues to monitor the pressure in the patient container 42 as more ventilation gas is supplied. When the controller 60 determines that the inhalation timer has expired, the controller 60 stops supplying the ventilation gas to the patient using the valve assembly 46 as a storage mode.

  Thereafter, in step 136, the controller 60 determines the tidal volume of the ventilation gas supplied to the patient. The controller 60 can determine the tidal volume based at least in part on the change in pressure within the patient container 42. For example, tidal volume can be determined, for example, by simply measuring the change in pressure in the pressure vessel during the inspiration cycle without requiring the duration and / or flow rate of the gas supply. At room temperature, air and oxygen are ideal gases and the volume of the pressure vessel is unchanged. Thus, the controller 60 can use the ideal gas law (pV = nRT) to derive the moles of gas provided by the pressure vessel during inspiration. The controller 60 can then determine an amount of gas equal to the tidal volume under patient airway pressure.

  The controller 60 can determine the minute ventilation by dividing the total tidal volume inhaled during the past minute every minute by minute.

  In step 138, the system 10 initiates exhalation, and in step 140 the patient pressure may be monitored using, for example, the patient airway sensor 70c. In step 142, the controller 60 may periodically check whether the minimum expiration time has elapsed. If the minimum expiration time has not elapsed, the controller 60 may return to step 140 and continue to monitor patient pressure.

  Optionally, when the minimum expiration time has elapsed, the controller 60 checks to see if artificial ventilation is required (ie, whether too long has elapsed since the patient's last inspiration). May be. Whether artificial respiration is necessary is determined by checking whether the artificial respiration timer has elapsed. When the artificial respiration timer has elapsed, the controller 60 may start inhalation. If ventilation is not required, the controller 60 may determine whether the patient airway sensor 70c detects a pressure less than the PEEP value in the controller's memory. Thereafter, the controller 60 may start inhalation.

If the patient airway pressure measured by the patient airway sensor 70c is still higher than the PEEP value stored in the memory of the controller, the controller 60 may determine a preset number of previous measurements from the patient airway sensor 70c, e.g. About 5 samples are extracted to see if the change in pressure over time is below the inspiratory trigger limit, eg, less than about −2 cmH ₂ O per 0.1 second.

  If the change in pressure over time is greater than or equal to the inspiratory trigger limit (which is less than or equal to zero), the controller 60 may return to the algorithm step to determine if the artificial respiration timer has elapsed.

  If the change in pressure over time is greater than the inspiratory trigger limit (which is less than or equal to zero), the controller 60 indicates that the recent change in pressure over time is closest to the zero recorded for a given exhalation. You may make it confirm whether it is a change of a pressure with time (namely, whether inclination is flat). If the change in pressure over time is less than the inspiration trigger limit, the controller 60 checks whether the recent change in pressure over time is greater than a preset minimum slope value. If the most recent change in pressure over time is greater than the minimum slope value and the most recently recorded change in pressure over time is closest to zero for a given exhalation, the controller 60 will store the controller's memory. Alternatively, it may replace the previous PEEP value and be prepared to set the current pressure as the new PEEP value. The controller 60 may then store the most recent pressure change over time in its memory as the current “flattest” pressure change over time.

  If the recent pressure change over time is less than the minimum slope value, or if the recent pressure change over time is not closest to zero for a given exhalation, the algorithm sets the ventilation timer to zero. You may make it return to the step which confirms whether it is less than.

  Returning to FIG. 4, if the assist mode is selected during operation of the system 10, steps 150-162 may be performed. For example, at step 150, the patient pressure may be monitored periodically until the patient pressure drops below the aspiration threshold at step 152. When this occurs, in step 154, the system initiates aspiration, i.e., controller 60 begins supplying valve ventilation 46 to the patient via inhalation line 24 from patient container 42 with valve assembly 46 in a delivery manner. May be. At step 156, patient pressure is monitored periodically during the gas supply, and at step 158 it is determined whether the patient pressure has reached or exceeded the discharge threshold. When the patient pressure reaches or exceeds the discharge threshold, the gas supply may be stopped at step 160 and a tidal volume may be derived, as in the method described above. In step 162, dispensing is initiated and the patient container 42 is reinjected from the gas supply 20, as described above, to reset the algorithm.

  FIG. 5A shows an example of an intuitive user interface panel 62 provided on the system housing, as described elsewhere herein. Input controls are grouped based on priority. The most important functions (respiration rate, mode, pressure and quantity targets) are provided on the left side of the user, for example at a position 62d adjacent to the display screen 62b. The default setting button runs a software algorithm that, in volume control mode, average adult tidal volume or rate, eg, 500 cc and 12 bpm, or average pediatric tidal volume or rate, eg, The device is preset to either 200 cc or 14 bpm. Auxiliary controls for alarm setting and patient inspiration start are located further away from the display screen, for example, at position 62e on the right side of the user. In the illustrated embodiment, the character string on the control panel 62 is described at an angle of 45 ° so that it can be easily read from both the vertical and horizontal directions. As shown in FIG. 5B, the character string on the display screen 62 may be turned again by the gyroscope control so that the ventilation system 10 looks upright when the ventilation system 10 is in a vertical or horizontal orientation.

  FIG. 5B also shows an exemplary embodiment of a housing 12 for the artificial respiration system 10 as described above. As shown, the housing 12 may have a rounded prism shape, for example, an elongated equilateral triangle shape. The three sides of the housing 12 are substantially smooth, which can facilitate storage and / or reduce the risk of damaging the components of the system 10. Optionally, one end of the housing 12 can include a recess within which all connectors 13 for connecting external components such as gas sources, power supplies, patient circuits, etc. (not shown). Is placed. Thus, the recesses can protect the connector 13 from damage and / or facilitate stacking of the plurality of housings 12 one by one while minimizing interference with the connector 13.

  Additionally or alternatively, if desired, the end of the housing 12 may be, for example, an outer periphery of the end to reduce the risk of damage to internal components due to, for example, dropping or impacting the housing 12 A rubber or other absorbent shock absorber can be included that extends around. Additionally or alternatively, both ends of the housing 12 have a male / female shape, for example, whereby the male end of one housing 12 is nested within the female end of another housing 12. For example, the multiplexing system 10 may be easily stacked or stored.

  It will be apparent to those skilled in the art that various changes and modifications can be made to the present disclosure and equivalents employed without departing from the spirit and scope of the invention. Elements shown in any variation are examples for a particular variation and may be used in other variations within this disclosure. Any element described herein as singular can be plural (ie, anything described as “1” can be greater than one). Any species element of a genus element can have the characteristics or elements of other species elements of the family. The above-described configurations, elements or completed assemblies and methods and their elements, variations of aspects of the invention for carrying out the invention can be combined and modified with each other in any combination.

  Exemplary embodiments of the present invention are described above. Those skilled in the art will recognize that many embodiments are possible within the scope of the present invention. Other changes, modifications, and combinations of the various components and methods described herein are certainly possible and are within the scope of the present invention. For example, any of the processing devices described herein may be combined with any of the delivery systems and methods described herein as well. Accordingly, the invention is limited only by the following claims and equivalents thereto.

Claims (21)

A ventilator,
A compressor that draws external gas into the ventilator and compresses the gas to one or more desired pressures to provide ventilation gas ;
A patient container;
A first pressure sensor connected to the patient container for detecting the pressure of the ventilation gas in the patient container;
One or more valves in communication with the compressor via a source line, in communication with the patient container, and in communication with an inspiratory line for delivering ventilation gas to the patient;
The one or more valves connected to the one or more valves, the reservoir mode in which ventilation gas is sent from the compressor into the patient container, and the ventilation gas from the patient container via the inhalation line A controller that selectively switches between a supply mode sent to a patient, wherein in the supply mode, the inspiratory line is exposed only to ventilation gas in the patient container and is separated from the compressor, The one or more valves are configured;
The controller is connected to the first pressure sensor to detect a first pressure in the patient container when the one or more valves are in the delivery mode, after which the ventilation gas Detects later pressure while is being sent from the patient container to the patient via the inspiratory line,
The ventilator determines the amount of ventilation gas to be delivered to the patient based at least in part on the difference between the first pressure and the subsequent pressure. The ventilator of claim 1,
Further comprising a flop refill container,
In the supply mode, the compressor communicates with the prefill container to send pressurized gas into the prefill container, while in the storage mode, the patient container is fed from both the compressor and the prefill container. A ventilator, wherein the one or more valves are connected to the compressor and the prefill container to communicate with the compressor and the prefill container for receiving pressurized gas. A ventilator,
A compressor that draws external gas into the ventilator and compresses the gas to one or more desired pressures to provide ventilation gas ;
A prefill container;
A patient container;
One or more valves in communication with the compressor via a source line, in communication with the prefill container and the patient container, and in communication with an inspiratory line for delivering ventilation gas to the patient;
Connected to the one or more valves, through which the ventilation gas is sent from the patient container to the patient via the inspiratory line and pressurized gas is sent from the compressor to the prefill container. And a controller for selectively switching between a supply mode in which the pressurized gas is sent from the compressor and the prefill container into the patient container and the pressurized gas is stored in the patient container. ,
The controller is connected to the first pressure sensor to detect a first pressure in the patient container when the one or more valves are in the delivery mode, after which the ventilation gas Detects later pressure while is being sent from the patient container to the patient via the inspiratory line,
The ventilator determines the amount of ventilation gas to be delivered to the patient based at least in part on the difference between the first pressure and the subsequent pressure . The ventilator according to claim 1 or 3,
The controller is configured to detect a later pressure in the patient container at a preset time interval after the one or more valves are in the delivery mode;
The ventilator wherein the controller determines an amount of ventilation gas to be delivered to the patient based at least in part on the difference between the first pressure and the subsequent pressure. The ventilator of claim 4,
The controller compares the estimated cumulative amount of ventilation gas delivered during each time interval with a preset maximum amount and when the estimated cumulative amount reaches or exceeds a preset maximum amount, A ventilator characterized in that the one or more valves are switched to close the inhalation line. The ventilator according to claim 1 or 3,
A ventilator wherein the controller is configured to determine the amount of ventilation gas to be delivered to a patient without requiring information regarding the flow of ventilation gas from the patient container. The ventilator according to claim 1 or 3,
A ventilator, wherein the controller is configured to determine the amount of ventilation gas to be delivered to a patient without information regarding the period during which the one or more valves are in the delivery mode. The ventilator according to claim 1 or 3,
The controller monitors the pressure in the patient container over time while ventilation gas is being sent from the patient container to the patient, and the time derivative of the pressure is close to the preset zero. The controller is configured to determine until a threshold value is reached, and as soon as the threshold value is reduced, the controller closes the inspiratory line and stops supplying ventilation gas from the patient container to the patient. A ventilator characterized by operating the above valves. The ventilator of claim 3 ,
In the supply mode, the ventilator is characterized in that the one or more valves are configured so that the inspiratory line is exposed to only the ventilation gas in the patient container and separated from the compressor . . The ventilator according to claim 1 or 3,
The one or more valves include a first valve connected to the source line to open and close the source line and a second valve connected to the intake line to open and close the intake line. A ventilator characterized by that. The ventilator according to claim 1 or 3,
A ventilator wherein the source of pressurized ventilation gas includes a compressor that operates substantially continuously. The ventilator according to claim 1 or 3,
A ventilator characterized in that the source of pressurized ventilation gas comprises one or more sources of pure oxygen and pressurized air. The ventilator according to claim 1 or 3,
A ventilator further comprising a restrictor in the inhalation line for restricting a flow rate of ventilation gas sent from the patient container to the patient. The ventilator of claim 13,
A ventilator wherein the restrictor is adjustable to change the maximum flow rate in the inspiratory line to the patient. The ventilator according to claim 1 or 3,
A restrictor is further provided in the source line between the compressor outlet and the one or more valves to limit the pressure of ventilation gas sent from the source line to the one or more valves. A ventilator characterized by comprising. The ventilator according to claim 1 or 3,
A second patient pressure sensor connected to the inspiratory line for detecting pressure in the inspiratory line;
The controller is connected to the patient pressure sensor and monitors the pressure in the inspiratory line to determine when the patient starts inspiration, and immediately after the determination, the controller A ventilator characterized by switching the valve to the supply mode. The ventilator of claim 3,
In the storage mode, the one or more valves are in communication between the patient container and the compressor and prefill container for delivering pressurized gas from the compressor and the prefill container into the patient container. In the supply mode, the second flow path and the third flow path are defined, and the second flow path sends the ventilation gas in the patient container to the patient via the patient line. The patient container and the inhalation line are communicated with each other, and the third flow path communicates between the compressor and the prefill container for sending pressurized gas into the prefill container. Ventilator. The ventilator of claim 3,
The source of pressurized ventilation gas includes a compressor that operates substantially continuously while the one or more valves are switched between the storage mode and the supply mode. Ventilator. The ventilator of claim 3,
A container pressure sensor connected to the patient container for detecting the pressure of ventilation gas in the patient container;
The controller is connected to the container pressure sensor to detect a first pressure in the patient container when the one or more valves are in the delivery mode, after which one or more Detecting the subsequent pressure in the patient container at the above time interval;
The ventilator wherein the controller determines an amount of ventilation gas to be delivered to the patient based at least in part on the difference between the first pressure and the subsequent pressure. The ventilator of claim 19,
The controller compares the measured cumulative amount of ventilation gas sent during each time interval with a preset maximum amount, and from the supply mode when the measured cumulative amount reaches or exceeds the maximum amount A ventilator characterized by switching the one or more valves to a storage mode. The ventilator according to any one of claims 1 to 20 ,
A ventilator characterized in that the internal volume of the flow path from the source line to the inspiratory line, including the internal volume of any container and valve, is at least 900 cc.

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